Individual ProviderAlyssa Ann ClarkSpecialist/TechnologistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address1150 Edina St, Dubuque, IA 52001-4203(815) 276-1089PECOS EnrollmentBased on the most recent information from CMS, provider Alyssa Ann Clark does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1619509569Provider TypeIndividualFull NameClark, Alyssa AnnGenderFemaleSole ProprietorNoEnumeration Date2/9/2020Last Updated2/9/2020Contact InformationPractice LocationPractice Address1150 Edina St, Dubuque, IA 52001-4203Phone(815) 276-1089FaxUnlisted FaxMailing LocationMailing Address1150 Edina St, Dubuque, IA 52001-4203PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode2255A2300XPrimaryDescriptionSpecialist/TechnologistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted Issuer